Episode 3 A&E on the Road


Episode 3

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Transcript


LineFromTo

Racing to treat a patient in need of critical care.

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Yeah, 5-2, can I have a crew, please?

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This is the West Midlands Ambulance Service.

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This could've been a fatal incident, 100%.

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A dedicated team of doctors and paramedics.

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-Hi there, your ambulance.

-Don't like it when they cry.

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They respond to a million 999 calls every year.

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SHE GROANS Fighting to save lives.

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Basically, went straight up in the air, crashing down.

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Because some emergencies are so severe...

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-He's fractured his femur.

-..treatment must begin...

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-Take a deep breath in, mate.

-..out on the road.

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I am grateful to every paramedic.

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If I could give him a medal, I would.

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AMBULANCE SIREN

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Today, a near fatal motorbike crash.

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I basically went straight up in the air, about 20 to 25 feet.

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A toddler needs help after a seizure.

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It's a real pressure, dealing with children.

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And the smaller they are, the more pressure you feel.

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And John treats a woman in unbearable pain.

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I've had very dark days - and I have cried and cried.

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AMBULANCE SIREN

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Working alongside the West Midlands Ambulance Service paramedics

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is a voluntary organisations called BASICS.

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BASICS stands for the British Association

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of Immediate Care Specialists.

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-BEEP

-Roger, many thanks. Out.

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It's purely charitable, what we do. It's all in our own time.

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Just aiming to bring the skills that we've learned

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and use every day in the hospital,

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and taking those out to work alongside paramedics,

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and just assist them in these more complicated injuries.

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OK, we're going to a two-year-old girl,

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who's been found by her mum, fitting.

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The most common cause of fitting in young children is having a high

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temperature, or being diagnosed with epilepsy.

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Around one in 50 children will have a febrile convulsion or fit

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before they turn five.

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-How do we get in to you? Round here?

-Round this way.

-Okey doke.

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In the worst case scenario, a fit can be life-threatening.

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INDISTINCT SPEECH

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Ben needs to quickly assess the toddler.

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-OK, hello there.

-Hiya...

-How are we doing?

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INDISTINCT SPEECH

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Has this young one been diagnosed with fits before?

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She's had a fit before, cos of a high temperature.

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-OK.

-But she hasn't been diagnosed with epilepsy or anything like that.

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OK. Let's have a quick...

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'Ashanti's temperature was way above 39 degrees,

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'so she was very, very hot.

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'Much too hot for a baby.'

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And that's almost certainly why she fitted.

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So what was she doing earlier?

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She was lying on the sofa with me, then, next minute,

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-I just noticed that she was fitting.

-OK.

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Fine. And when you say fitting, what do you mean by fitting?

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-Foaming from the mouth a bit.

-OK, OK.

-Shaking.

-Shaking.

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And she's stopped shaking since then.

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-Yeah, she's stopped shaking.

-How long did the shaking last?

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-About ten minutes.

-Big stretch.

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Hello there, sweetie.

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Aren't I horrible?

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Let's pop your finger in there.

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So, sometimes people do fit again, OK?

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So don't be worried, she's got the right people here now,

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and we've got an ambulance on the way, and we will be going in. OK?

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It's a real pressure, dealing with children.

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And the smaller they are, the more pressure you feel.

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ASHANTI BREATHES HEAVILY

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Well done. Thank you very much. So this is just a little bit of oxygen,

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because her oxygenation isn't perfect.

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It's nothing that I would be worried about, but I can...

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Oh, look at that.

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One of the causes of a fit could be not enough

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oxygenation in the brain. So we give it for that reason.

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The other reason is we want to make sure there's plenty of oxygen

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getting to the brain,

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because there's increased brain activity during a fit.

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I've never seen a child have a fit.

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Oh, dear. It's not nice, is it? Especially not when you're Mum.

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All right.

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All right, sweetie... Hello there. Let's just leave you where you are.

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Well done.

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The ambulance team arrive and Ben updates them on Ashanti's condition.

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She's coming round a bit. She's eye-opening.

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We'll just see what the BM is.

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Do you mind taking over the head end and just...?

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She's maintaining her own airway.

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The respiratory rate's 24, erm, and GPS is picking up as we go along.

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She's just eye-opened spontaneously.

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I'll just have a quick word with your crewmate

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and I'll give him a hand getting

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-everything prepared so we can get her into hospital.

-Smashing.

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Concerned Ashanti may have another fit in the ambulance,

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the crew need to be ready to deal with it.

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We want to have intravenous access, so we can give the necessary drugs

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in order to stop any further fitting.

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But hopefully, if we can get her temperature down,

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we can reduce the risk of that.

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-ASHANTI CRIES

-OK.

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Ben, if you... The head end is at the far end,

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so if you want to lay her down here.

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That's great. And if you want to sit next to her.

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OK. Well done.

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Ashanti's dad, Rich, has rushed home to be with her.

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What you been doing? Hiya. What's happened? It's all right.

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Sometimes they get a bit confused after a fit,

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so she might not be recognising you particularly much,

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but that's just cos she's had a fit. OK? Nothing to worry about.

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What's happened?

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Now, I'm going to try to put a little plastic needle in her hand,

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so if you want to concentrate on leaning over that side,

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so she can see you over there.

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-Asha.

-OK.

-Over here, babe.

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-Well done. Well done.

-Well done.

-OK.

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-It's all right.

-I need to pop a cannula in.

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If she is going to fit again, I need to be able to give her drugs.

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Erm... And the only way we can reliably give drugs

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is by giving them into her vein,

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so if we can easily get access, we'll get it.

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OK, so a horrible scratch coming up for her, so...

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VOICES TALK OVER EACH OTHER

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Nasty scratch.

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ASHANTI CRIES

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-OK, my love. OK.

-It's all right.

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A bit of a high temperature and a bit of a high sugar,

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so what we're doing, we'll just run her in, just to make sure that everything's OK.

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Erm, there could be 101 things, especially with children.

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They can do really well and then crash really easily,

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but it don't seem the case, so it's all just playing it safe for the moment.

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AMBULANCE SIREN

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What's our ETA?

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BEEPING

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-It's OK.

-Ooh, dear.

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Eight minutes. Brilliant.

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She has a temperature, initial temperature of 40,

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which has come down to 37.8 now.

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She hasn't fitted since

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and her level of consciousness has improved since then,

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so she's now eye-opening spontaneously.

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A little bit confused, not particularly attentive to Mum.

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But I think she's probably someone who'd benefit

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from either coming to resus or the children's area,

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just to be kept an eye on, maybe some intravenous paracetamol,

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erm, you know, et cetera.

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Our ETA is six minutes from now, OK?

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'Mum was really quite distressed by this,

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'but she did an absolutely excellent job.'

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Yeah, go on, follow alongside, hold her hand if you want to.

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'I want to reiterate to her what a great job she did.'

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At Royal Stoke University Hospital,

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Ashanti is taken into the children's area.

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-Hello, hello, hello.

-Hello.

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-How are you doing?

-Hiya.

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This is young Ashanti.

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-She's two years old.

-Mm-hm.

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She's had one previous episode of a, erm, febrile convulsion.

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ASHANTI CRIES

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-Oh, dear.

-Oh, no...

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I don't like it when they cry.

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Hopefully she won't fit again,

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but if she does, she's in the right place.

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They've got better lighting,

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they've got full equipment, they've got more pairs of hands.

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So if she fitted again,

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we'd be in the right place, pop some IV access in

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and give her any appropriate drugs.

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-OK? Right, take care.

-Thank you for helping.

-Bye-bye.

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Today, she was just lying down on the sofa, behind her mum's legs.

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Her mum felt a couple of kicks, thought she was playing,

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and she turned around and saw that she was having

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a convulsion...

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and then got on the phone to me,

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and I had to go, get back sharpish, type of thing.

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So...scary. Very scary.

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You know. I'll have a little cry about it later.

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Off camera, of course.

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The good news is that Ashanti was given the all-clear

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and discharged from hospital the next day.

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AMBULANCE SIREN

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The rapid response vehicles were set up

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because we can get through traffic quicker.

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Every second counts when somebody's critically ill,

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and we can get there and stabilise the patient

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before the ambulance gets there.

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I used to have my own business, I did hair and beauty,

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and also I worked for Richard Branson on Virgin Atlantic.

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I was an in-flight beauty therapist for six years.

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It's not much different, I still deal with the public,

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erm, still have interesting days,

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but unfortunately, not going to the exotic locations that I used to.

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Today, Simone is heading to the scene of a motorbike accident.

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We're going on the way to Kidderminster,

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and it's a motorcyclist versus a car.

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All the information we have at the moment is the car driver

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is very shaken and the motorcyclist seems badly injured.

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So, obviously with the nice weather, a lot of motorcyclists are about,

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especially on this stretch of road.

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It tends to go out into the country a little bit more.

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It's a fast road and it's obviously very straight,

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so we do have quite a few.

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Hi there. Who is the driver of the vehicle?

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Were you on your own? Are you OK? Yep.

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A consultant paramedic and a passing nurse are already on scene.

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The worst thing to see is somebody on the floor and they haven't moved,

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cos most people will get themselves up.

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But if you see a motorcyclists lying on the ground, you know,

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you fear the worst.

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Whereabouts is it? Is it below your elbow?

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-On the elbow.

-On your elbow.

-Just on your elbow.

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We're going to have to cut your jacket, OK?

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Can I move this arm? I'm just going to put some sticky dots on...

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'We checked his full vital signs to make sure there was no other injury,

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'cos it can be distracting, cos you're in pain,

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'but other things, more serious, are going on.

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'Neck, back-wise, spinal injuries.'

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We're looking, erm,

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obviously for life-threatening injuries, for bleeds.

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The biker was on his way to work when the accident happened.

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As I came round the corner,

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I saw a car.

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It was indicating to turn,

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so I started to slow down a little bit.

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And as I got to the first entrance of the pub, he decided to go.

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From what I've been told, when I impacted,

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I basically went straight up in the air, about 20 to 25 feet,

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and then I came crashing down,

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headfirst, straight into the tarmac.

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I don't remember the impact.

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I remember looking up and seeing blue, bluey-grey sky.

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The next thing I remember is waking up to the paramedics working on me.

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Do you remember everything, Simon? Everything that happened?

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-Not exactly, no.

-Not exactly.

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INDISTINCT SPEECH

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HISSING SOUND

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Still no pain anywhere else?

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-Just my left arm.

-Just your left arm, still your left arm, all right.

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When we go into a high impact job,

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we do expect broken-boned people can bleed

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and lose excessive amounts of blood,

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so we are very aware that we do need to make sure

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that this isn't going to cause

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catastrophic haemorrhage for the patient.

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There's a bit of blood on your...

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coming from your jacket. Can you ascertain where that's from?

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I'm cutting your jacket.

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I was just saying, he's got the right kit on, chaps.

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-He has...

-We were just was saying that as we were coming.

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'I do remember hearing the paramedics talking.

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'The things that I could hear didn't sound good.

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'I was concerned about internal bleeding.'

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Although I've got my bike gear on,

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there is the nickname of bike gear as the body bag.

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To hear the Air Ambulance in the sky,

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when I heard that, I was quite scared for how bad, injured I was.

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I thought at first it was just my arm, and just cuts and bruises.

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But to hear the Air Ambulance,

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it made me think that I'd had a lucky escape.

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All right, sweetheart.

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OK.

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Do you think you lost consciousness, at all?

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-You don't know what's happened.

-Don't worry.

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The paramedics decide to take Simon to hospital by road ambulance.

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Hi there.

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Just can we get the stretcher? And we'll get the thing and everything, yeah.

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-That's great.

-That's great.

-It's really, really hurting.

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-OK?

-All right.

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I'm going to give you some oxygen, that will help.

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It is going to be a bit painful,

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cos we're going to put this splint on your arm, Simon.

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-That's the morphine. Keep breathing that gas.

-Deep breaths.

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'Any broken bones that we find, we want to immobilise them.'

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It will help with the flow of oxygen, the flow of blood.

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Unfortunately, it is going to hurt.

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-SIMON GROANS

-Sorry, sweetheart.

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-Sorry.

-Deep breaths.

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With Simon, there was a high probability that he might have spinal injury,

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so we have to immobilise him,

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and then we use head blocks and try to...

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Limited movement for him, so there's no more damage,

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if there was any damage to his spinal cord.

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-OK. Ready?

-Yeah.

-Steady, roll.

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Well done, Simon. Well done, well done, well done.

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When he gets to hospital, Simon will be given a full body scan.

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We're just going to lift you now, Simon.

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So if you just put your arm there, that'll be great.

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-OK? Ready?

-Ready, steady, lift.

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There we go.

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Simon suffered some serious injuries,

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but something positive also happened

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because of his accident.

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Prior to the accident,

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me and my wife were going through a separation.

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The day of the accident,

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it made me realise, and I remember being...

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laying on the road, just asking for my wife.

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I heard that he'd been in a full bike accident and he was going

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for a full body scan. I was thinking, I need to get to

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the hospital, I need to get to him. When I finally got there,

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I just couldn't believe the sight I saw.

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I'll never get that image out of my head,

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where he was covered in blood.

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His mouth was just... You couldn't see his teeth for blood.

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When my wife turned up, she just walks in,

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takes my hand and gives me a cuddle and says, "You're going to be OK."

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And it was the words I needed to hear.

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Scans revealed no internal bleeding or spinal damage, but Simon has

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shattered his elbow in five places.

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He believes he's lucky to be alive.

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Looking at my bike gear,

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it looks like I've put my left arm out

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against my forehead, which saved my life.

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Although I've broken my elbow,

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if I hadn't have put my arm up,

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then potentially, I could've bent my head back

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and snapped my neck.

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Sorry, sweetheart.

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OK. Whereabouts is it hurting?

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My arm is really, really hurting.

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-RACHEL:

-Just seeing it, seeing all that blood.

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-Going to give you some oxygen, that will help.

-I knew it was bad...

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Seeing it like that is...

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-Oh, my God.

-SIMON GROANS

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Sorry, sweetheart. Sorry.

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The accident may have saved their marriage.

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Whee!

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Choo-choo!

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Yeah, we're going to try to make it work for our daughter and for ourselves,

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cos it's obvious that there's still a lot of feelings there.

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It has brought us closer, put things into perspective with

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what's important, and hopefully we'll see if we can sort things out.

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Obviously, I won't be getting on another motorbike again,

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because of Mary.

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I don't want to risk the next time something happens

0:16:110:16:15

to not survive it and then leave Mary without a dad.

0:16:150:16:18

AMBULANCE SIREN

0:16:210:16:22

I have been in the Ambulance Service for 16 years now.

0:16:280:16:31

I've been a paramedic for just nearly ten.

0:16:310:16:34

The worst thing about being a paramedic, it's the strain

0:16:340:16:37

within the service. The amount of jobs that we do.

0:16:370:16:40

They're escalating, they're getting bigger and bigger by the day.

0:16:400:16:42

The best thing, it's the ultimate, it's saving someone's life.

0:16:420:16:45

Being there and the actions you do actually saves someone's life.

0:16:450:16:48

I don't think there there's any other feeling that you can have.

0:16:480:16:51

In 16 years, it's done me fine, fingers crossed.

0:16:510:16:55

Today, John is going to treat a woman experiencing extreme pain.

0:16:570:17:00

Currently on our way to a lady who is suffering with severe

0:17:000:17:05

abdominal pain. Said it's going into her back and into her groin.

0:17:050:17:09

Could be a multitude of different things, really.

0:17:090:17:11

Anything from kidney stones to a water infection.

0:17:110:17:14

We'll see what the history is before we get there

0:17:140:17:16

and see if we can help her out.

0:17:160:17:19

-Down here.

-John's a regular visitor to this patient.

0:17:290:17:32

-Oh, hello. I've met you before!

-HE LAUGHS

0:17:320:17:35

So, what's been going on again? Remind me.

0:17:350:17:38

-I've slept since.

-Keep getting this pain in me stomach.

-Yeah.

0:17:380:17:42

-Me groin and me leg.

-OK.

-I keep having flare-ups.

0:17:420:17:45

I was great, I've been down the park with the kids,

0:17:450:17:48

I've done nothing strenuous, have I?

0:17:480:17:50

It's just come on with a vengeance.

0:17:500:17:52

SHE GROANS

0:17:530:17:55

'It started off three years ago.'

0:17:550:17:57

I had this really intense pain.

0:17:570:17:59

I thought it was appendicitis,

0:17:590:18:02

and so did the doctors when I got to hospital, but it wasn't.

0:18:020:18:06

They did every test imaginable.

0:18:060:18:09

I was in there for four days and they couldn't find out what it was.

0:18:090:18:13

And after that, it seemed to be every week

0:18:130:18:16

I was calling an ambulance for this pain, excruciating.

0:18:160:18:20

I can't explain how bad it was.

0:18:200:18:23

I'm in agony.

0:18:230:18:25

I've had three children

0:18:250:18:27

and I would rather give birth five times than go through that pain.

0:18:270:18:31

-And it comes in spasms.

-BEEPING

0:18:320:18:35

Oh...

0:18:350:18:36

It's me back.

0:18:370:18:39

-Right.

-I've lost two discs in me back.

0:18:390:18:41

-Right.

-And me bones are crumbling.

0:18:410:18:44

-And it's dust hitting the nerves.

-BEEPING

0:18:440:18:47

-OK... It's all right.

-Ah...

0:18:470:18:49

Wendy's condition is chronic.

0:18:490:18:51

All John can do is offer her relief from her pain.

0:18:530:18:56

Get a cannula into her hand.

0:18:560:18:58

-Give her some morphine, we'll pop up to...

-INDISTINCT

0:18:580:19:00

-This lady... She's known to me.

-HE LAUGHS

0:19:000:19:03

She's, erm, had a long standing issue with this, problems,

0:19:030:19:06

with the pain going down to her arm.

0:19:060:19:08

She's waiting to see the pain clinic.

0:19:080:19:10

Basically, long-term chronic pain relief.

0:19:100:19:12

-Needle in.

-Ah...

-BEEPING

0:19:140:19:16

Ooh...

0:19:160:19:18

Let's have your right hand, sweetheart.

0:19:180:19:20

Yeah, but wait till this goes.

0:19:200:19:22

Ooh!

0:19:220:19:23

BEEPING

0:19:240:19:25

-Sorry.

-That's all right.

0:19:270:19:29

I hate these.

0:19:290:19:31

'You do get used to seeing people in pain.

0:19:310:19:32

'That's definitely part of the job.'

0:19:320:19:35

It's worse to deal with when you can't do anything about it.

0:19:350:19:38

We've got quite significant pain killers we can give intravenously,

0:19:380:19:42

but when you've given all that you can give and they're still in pain,

0:19:420:19:46

it's quite hard to deal with.

0:19:460:19:49

You can have...

0:19:490:19:50

All you can offer them is sympathy, really.

0:19:500:19:53

It shouldn't take three years, should it, to be pain free?

0:19:530:19:57

The problem is, we don't really know what's causing it, do we?

0:19:570:20:00

-No.

-If you don't, it's...

0:20:000:20:03

When you don't know what's wrong with you, but you're in constant,

0:20:030:20:07

constant pain, you do get angry and frustrated.

0:20:070:20:11

You know, what the hell is going on?

0:20:110:20:13

Am I going to die? And you do think that a lot.

0:20:130:20:16

I've had very dark days - and I have cried and cried,

0:20:160:20:19

and it's an awful thing to say to your children,

0:20:190:20:21

but I've even said to my children,

0:20:210:20:24

if this is the rest of my life, I don't want it.

0:20:240:20:28

BEEPING

0:20:290:20:30

How are you feeling now?

0:20:300:20:32

-A bit better.

-Anything kicking in?

0:20:320:20:34

Anything making you feel funny?

0:20:340:20:37

-Sorry?

-Anything making you feel funny?

0:20:370:20:39

No, I'm all right. Just itching.

0:20:390:20:41

-Just my arm's itching.

-And that's normal for you?

-Yeah.

0:20:410:20:44

It's instant, as soon as the morphine goes in, me arm itches.

0:20:460:20:50

It's ever such a funny sensation.

0:20:520:20:54

-What is?

-Oh, you can feel it all up here.

0:20:540:20:57

BEEPING

0:20:570:20:58

It's a good job I've hit the right one, then.

0:20:580:21:00

WENDY LAUGHS

0:21:000:21:01

18 minutes after being given the morphine,

0:21:040:21:07

Wendy is on her way to hospital, to be given even stronger pain killers.

0:21:070:21:11

And from that day on, things finally started to improve.

0:21:150:21:19

I changed doctors - and she was marvellous,

0:21:190:21:22

and got me to see different specialists.

0:21:220:21:25

And things started to really move, then.

0:21:250:21:27

And I had an MRI scan, and I finally had a diagnosis.

0:21:270:21:31

After three years. It was amazing.

0:21:330:21:34

WENDY LAUGHS

0:21:340:21:36

I've been diagnosed with disc degeneration.

0:21:360:21:39

After the diagnosis, I went in for a procedure, which I think,

0:21:390:21:45

hope, has worked. I had injections in my back, into my nerve endings,

0:21:450:21:49

and I've only had the pain once since.

0:21:490:21:53

-So, we might be getting there now.

-WENDY LAUGHS

0:21:530:21:56

It feels absolutely amazing.

0:21:570:22:00

It really does.

0:22:000:22:01

I feel like I've got a life again,

0:22:010:22:04

cos my life was put on hold for three years.

0:22:040:22:07

In those days, I just felt that life wasn't worth living.

0:22:070:22:11

I am so grateful to every paramedic I have seen.

0:22:110:22:15

They are worth their weight in gold.

0:22:150:22:17

They really are. If I could give them a medal, I would.

0:22:170:22:20

WENDY LAUGHS

0:22:200:22:22

AMBULANCE SIREN

0:22:220:22:23

The West Midlands Ambulance Service has 100 rapid response vehicles,

0:22:290:22:34

all crewed by single paramedics with advanced skills.

0:22:340:22:37

We drive a fast car,

0:22:400:22:42

and we tend to get there first on scene.

0:22:420:22:45

We're used in different ways. If it's a real serious job,

0:22:450:22:49

they will respond us, as well as an ambulance.

0:22:490:22:52

With a job with less priority,

0:22:520:22:55

Control will tend to wait on our say,

0:22:550:22:58

so if we need any backup.

0:22:580:22:59

Today, Kathryn is on her way to treat a teenager,

0:23:020:23:05

suffering from a debilitating illness.

0:23:050:23:07

We've got a 15-year-old with Crohn's disease,

0:23:070:23:10

and he's got severe abdominal pain.

0:23:100:23:12

Hello!

0:23:230:23:24

-Straight through?

-Yeah, straight through.

0:23:240:23:26

-There you go.

-What's been going on, then?

0:23:260:23:29

Hello, young man.

0:23:290:23:30

-He's been vomiting.

-Right.

-And he's just not well today.

0:23:300:23:34

He said, "Mum, I'm not well, I don't feel well."

0:23:340:23:36

I didn't feel right that day,

0:23:360:23:38

cos I got out of the car and I was sweating.

0:23:380:23:40

I just felt dizzy. I went as white as a ghost.

0:23:400:23:45

And then, all of a sudden, I just started being sick.

0:23:450:23:48

He's got Crohn's disease.

0:23:480:23:50

-Yes?

-So, it's in his stomach, his large colon and his genitals.

0:23:500:23:55

Right. I'm just going to do a few little observations on you.

0:23:550:23:59

Is that OK? Yeah? Kyle?

0:23:590:24:02

If we had a score of one to ten, one being a little pain,

0:24:020:24:08

ten being a massive pain, what would you put it at?

0:24:080:24:12

-Ten.

-So, it's that bad. All right.

0:24:120:24:14

The pain felt like someone was

0:24:140:24:16

just repeatedly kicking me in the stomach, over and over.

0:24:160:24:20

I gave Kyle a drug called Entonox,

0:24:200:24:23

which is basically gas and nitrous oxide.

0:24:230:24:27

Have you ever had any gas and air before?

0:24:270:24:29

Entonox, yeah?

0:24:290:24:31

It is brilliant as a first-line pain reliever.

0:24:310:24:36

-Is that OK?

-Mmm...

0:24:360:24:38

-Is that OK, Mum?

-Yeah, that's fine.

-OK.

0:24:380:24:40

And then, we'll get some little observations done on you.

0:24:400:24:43

All right.

0:24:430:24:45

Let me just get you some transport.

0:24:450:24:47

52, thank you, we'll have an amber response, please. He needs to go in.

0:24:470:24:51

-What was that, mate?

-I'm really cold.

0:24:530:24:55

Oh, no. Let's get you covered up a bit,

0:24:550:24:57

and then we'll do some observations on you. Has it been this bad before?

0:24:570:25:02

It has.

0:25:020:25:04

Kyle was diagnosed three months ago, after suffering for two years.

0:25:060:25:10

All right, and just have a...

0:25:100:25:12

You need to make a noise.

0:25:120:25:14

-RASPING SOUND

-That's it. That's the noise.

0:25:140:25:17

When a child is quiet,

0:25:170:25:20

it's usually an indication that they're poorly.

0:25:200:25:23

Keep going with that. It might make you go a little bit light-headed,

0:25:230:25:26

sweetheart, but it'll help with that pain, all right?

0:25:260:25:30

And with Kyle, he was listening,

0:25:300:25:31

and he was talking to me, but not really making conversation.

0:25:310:25:36

But as he was taking the gas and air,

0:25:360:25:39

he started to relax a lot more and talk to me a lot more.

0:25:390:25:42

You're not supposed to be bad in the school holidays!

0:25:440:25:47

It's term time to be bad!

0:25:470:25:49

-Oh, do you? Because of your condition?

-Yeah.

-Dear me.

0:25:510:25:55

I'm just going to pop this in your ear, my love.

0:25:560:25:58

Keep sucking on that.

0:25:580:25:59

HISSING SOUND

0:25:590:26:00

OK.

0:26:030:26:04

Temperature's OK.

0:26:040:26:06

Is it just taking the edge off it a little bit for you?

0:26:060:26:09

Suck a bit harder.

0:26:090:26:11

That's better. That's better.

0:26:110:26:13

All right. It will help.

0:26:130:26:15

-All right, Mum?

-Yep.

0:26:150:26:17

OK.

0:26:170:26:19

I've never seen my son like that, ever.

0:26:190:26:21

I thought I'd lost him.

0:26:210:26:23

I always say, trust Mum's instinct, they know best.

0:26:230:26:27

And she knows that Kyle's quite poorly today,

0:26:270:26:30

and she's had the good sense to ring an ambulance,

0:26:300:26:33

so we're going to pop him up the hospital.

0:26:330:26:35

All of his obs are OK,

0:26:350:26:37

but he's not OK, so we need to get this sorted.

0:26:370:26:41

The Entonox really seemed to help him and relax him.

0:26:410:26:45

By the time the crew got there,

0:26:450:26:48

he was a lot more relaxed in his stance, as well.

0:26:480:26:50

You could see. You've got one of the best paramedics in the world here.

0:26:500:26:54

-All right, then. Hello.

-Hiya.

0:26:540:26:56

This is Kyle. He's always in pain. Right?

0:26:560:26:59

-But today, he's been in a lot of pain...

-Vomiting...

0:26:590:27:02

And he's been vomiting.

0:27:020:27:04

Not while I've been here. All of his obs are perfect.

0:27:040:27:07

OK?

0:27:070:27:08

Lost quite a bit of weight.

0:27:090:27:11

Now the crew are here, we're going to go down the line of giving him

0:27:110:27:14

some paracetamol, but in a drip.

0:27:140:27:16

-Yeah.

-Is that OK with you?

0:27:160:27:18

-Is that OK with you?

-As long as it gets me better, I'm happy.

0:27:180:27:22

-That's it.

-It will help take the pain away and then we'll get

0:27:220:27:24

the doctors to get you better, all right? Just pop them in.

0:27:240:27:28

-And the other one.

-VOICES TALK OVER EACH OTHER

0:27:280:27:30

It's quite hard on your bottom.

0:27:300:27:32

-All right.

-All right.

0:27:320:27:34

It was awful. He couldn't stand.

0:27:340:27:37

He didn't know where to go.

0:27:370:27:39

He was so thin.

0:27:390:27:40

He'd lost so much weight.

0:27:400:27:42

A bit of a bump, OK?

0:27:420:27:43

Backwards all right?

0:27:480:27:50

Nice and steady.

0:27:500:27:51

Ready?

0:27:510:27:53

Bring your feet up.

0:27:540:27:57

At least I've got some smiles now.

0:27:580:28:01

Smiles from Kyles!

0:28:010:28:02

Later at hospital,

0:28:040:28:06

they found the source of Kyle's pain was not his Crohn's.

0:28:060:28:09

They took bloods from him, they came to us and they said

0:28:090:28:13

Kyle was given a tablet called Azathioprine, for Crohn's disease,

0:28:130:28:19

but the trouble was, there is side effects with this drug.

0:28:190:28:23

Now, it doesn't affect everybody, but unfortunately,

0:28:230:28:25

Kyle was one of the people that it does affect.

0:28:250:28:27

When I got to the hospital, they found what was upsetting me,

0:28:270:28:32

which was the tablets.

0:28:320:28:33

They gave me morphine, paracetamol,

0:28:330:28:37

and everything, cos I was in too much pain.

0:28:370:28:39

The drug that Kyle was on for Crohn's

0:28:390:28:42

caused him to have inflammation of the pancreas.

0:28:420:28:46

It can be fatal if it bursts.

0:28:460:28:48

So, in one respect,

0:28:490:28:52

I was glad Kyle collapsed, because everything came to a head then.

0:28:520:28:57

Thank you to them for finding it, otherwise it could've been fatal.

0:28:570:29:02

Cos, as my pancreas was swelling, it could've burst,

0:29:020:29:05

which could've killed me.

0:29:050:29:06

He was lucky. He was so lucky.

0:29:060:29:08

Kyle continues to work with consultants

0:29:100:29:12

at Birmingham Children's Hospital

0:29:120:29:14

to find ways of dealing with his Crohn's.

0:29:140:29:17

How have you been?

0:29:170:29:18

It could be better.

0:29:180:29:20

All the swelling's come back,

0:29:200:29:22

the redness, and it's weeping again, so...

0:29:220:29:24

-OK.

-And it's hard to walk again, so...

-OK.

-..I don't know what to do.

0:29:240:29:29

He's got a great group of doctors

0:29:290:29:31

who are helping him, and they get their heads together,

0:29:310:29:34

and I know somewhere down the line, they will sort him out.

0:29:340:29:38

I'm pretty confident that day will come.

0:29:380:29:40

It might take a few more years, but at least it will be gone,

0:29:400:29:44

and I just wish I could be normal, like everyone else.

0:29:440:29:47

AMBULANCE SIREN

0:29:470:29:48

More than 3.5 million people in the UK are living with diabetes.

0:29:540:29:59

There are quite a large amount of diabetic patients

0:29:590:30:01

within the population, but people manage themselves.

0:30:010:30:04

They know how to manage it on a day-to-day basis.

0:30:040:30:07

We only get called when it becomes a crisis,

0:30:070:30:09

when the blood sugars are too low, or too high.

0:30:090:30:12

For diabetic patients, the best thing is routine.

0:30:120:30:15

You can do whatever you want, really, in your life,

0:30:150:30:17

as long as it's kept in a routine.

0:30:170:30:19

John's in Stourbridge on his sixth job of the day.

0:30:190:30:23

We're off to a 76-year-old lady.

0:30:230:30:26

Just says she's got diabetic problems at the minute.

0:30:260:30:29

There's no further details.

0:30:290:30:30

I'm assuming the call's still in progress,

0:30:300:30:33

and they're trying to ascertain what's going on.

0:30:330:30:35

We've just had an update come through.

0:30:440:30:46

The lady is what they call a hypo,

0:30:460:30:48

so her blood sugar's gone too low for her to function properly.

0:30:480:30:51

If the blood sugar just keeps dropping,

0:30:510:30:53

basically, the body shuts down.

0:30:530:30:55

'Just ahead, turn right.'

0:30:550:30:58

So it really just depends quickly we can get there.

0:30:580:31:00

'You have reached your destination.'

0:31:000:31:03

Left untreated, a hypoglycaemic incident, or hypo, can be fatal.

0:31:060:31:11

-Hiya.

-Hiya.

-How we doing?

0:31:190:31:21

-She's managing to swallow.

-Excellent.

0:31:220:31:24

-So I'm giving her a bit of Lucozade.

-Super-duper.

0:31:240:31:27

-But I'm just wondering, you know, whether she's had a stroke.

-OK.

0:31:270:31:30

What we'll do, because they present in a similar way,

0:31:300:31:33

-we'll make sure the blood sugar's all right and deal with that.

-OK.

0:31:330:31:36

The best way to tell the difference between a stroke and a hypo

0:31:360:31:40

episode is basically we do a blood sugar test.

0:31:400:31:43

So a pinprick on the end of the finger.

0:31:430:31:46

If it's below four, we know the patient is hypo,

0:31:460:31:48

so we treat them for that.

0:31:480:31:50

How often does she have a hypo?

0:31:500:31:52

She hasn't had as many recently, but she's not been very well.

0:31:520:31:55

-She's on antibiotics for pneumonia at the minute.

-Right.

0:31:550:31:58

We'd just come up to visit my mum.

0:31:580:32:00

My dad said she'd been asleep for a couple of hours,

0:32:000:32:03

so my daughter came up to see how she was,

0:32:030:32:06

and she couldn't wake her.

0:32:060:32:08

All right. I'm just going to do your blood sugar again.

0:32:080:32:11

Come here, chicken. There we go.

0:32:110:32:13

Sharp scratch, my darling.

0:32:130:32:14

-2.1.

-That's a bit better.

0:32:180:32:20

-It was 1.6 when I did it.

-Okey dokey.

0:32:200:32:23

With the reading below four, a stroke is ruled out.

0:32:230:32:27

John prepares to raise Pat's blood sugar levels.

0:32:270:32:30

Has she had a Glucagon injection lately?

0:32:300:32:33

-No.

-She's quite well managed, then?

0:32:330:32:35

Well...

0:32:350:32:37

We can give an injection in the arm called Glucagon,

0:32:390:32:41

which is a synthetic hormone, which releases the body's own stores.

0:32:410:32:45

Well done, darling.

0:32:450:32:46

We can also give an intravenous drip of glucose 10%,

0:32:460:32:52

which is basically the body's rocket fuel.

0:32:520:32:55

As long as it's blood sugar, we know we can fix it here.

0:32:550:32:58

That's always the bonus with it.

0:32:580:32:59

That's all right.

0:32:590:33:01

Her blood pressure's fine, oxygen levels are OK.

0:33:010:33:04

Her ECGs are all looking good.

0:33:040:33:06

How we doing, Pat?

0:33:060:33:07

Are you with us yet?

0:33:090:33:11

-Is there a hint of realisation going on here now?

-Yeah.

0:33:110:33:14

Filthy looks.

0:33:140:33:16

We've given her the injection now,

0:33:160:33:17

so hopefully it will start to build up,

0:33:170:33:20

but obviously as the brain's getting more oxygen into the system,

0:33:200:33:23

Pat's becoming more aware of everything.

0:33:230:33:25

But Pat's blood sugar level has dropped, rather than risen.

0:33:250:33:28

0.9. You're going the wrong way!

0:33:280:33:31

Are you trying to play me up?

0:33:310:33:33

So John decides to try a different method.

0:33:330:33:36

Because the blood sugar's still going down,

0:33:360:33:39

so we'll just pop a needle in her vein

0:33:390:33:41

and give her some glucose intravenously,

0:33:410:33:43

and we'll take it from there.

0:33:430:33:44

Come on then, trouble.

0:33:440:33:46

I've got a sneaking suspicion,

0:33:480:33:50

-it's because she hasn't been eating well.

-Yeah.

0:33:500:33:52

Before John can put in a drip of more concentrated glucose,

0:33:520:33:56

Pat starts to come round.

0:33:560:33:58

-You're cold? We've got you talking.

-That's all right.

-That's better.

0:33:580:34:01

Well, I came up here to have a sleep.

0:34:010:34:05

-Yeah? You did.

-You did well, you succeeded!

0:34:050:34:08

What's been the matter with me?

0:34:080:34:11

-You've had a hypo.

-A hypo?

0:34:110:34:14

Yep, a good one this time.

0:34:140:34:17

John re-checks Pat's blood sugar levels.

0:34:200:34:22

She's sweating to death.

0:34:240:34:26

Oh, I was sweating.

0:34:270:34:28

-The blood's running.

-5.5 now.

-That's better.

0:34:310:34:35

It's taken 23 minutes for Pat's blood sugar level to return

0:34:350:34:38

to a healthy level since John first tested it.

0:34:380:34:41

-How long have you been here?

-Oh, hours!

0:34:410:34:46

When we've given the medication and they suddenly come out of this

0:34:470:34:51

unconscious and confusing state and look at you, it's quite nice,

0:34:510:34:54

because someone could die from that, but you've treated them,

0:34:540:34:57

and nine times out of ten, they're lovely people.

0:34:570:35:00

They're nice jobs to do.

0:35:000:35:01

Lift your arms up for me, Pat, can you? Excellent.

0:35:010:35:05

Pat's blood sugar has miraculously spiked up to a normal level.

0:35:050:35:09

We're going to give her something to eat, jam sandwiches and sweet tea,

0:35:090:35:12

hopefully that will bring the sugars up even more, so...

0:35:120:35:15

15 minutes later, Pat's almost back to her old self.

0:35:190:35:23

I can't ever remember anything like this.

0:35:230:35:27

I've had a hypo, but it's only like a small one, as you'd say.

0:35:270:35:34

She doesn't do what she's told,

0:35:340:35:36

but she doesn't seem to think that it's a problem.

0:35:360:35:39

She can eat when she wants, and drink when she wants,

0:35:390:35:42

and not check her blood sugars when she should do.

0:35:420:35:44

She's back to normal again now, making jokes and laughing,

0:35:470:35:50

so, that's my mum back again, yeah.

0:35:500:35:52

Initially, I thought I was going to have to give her some intravenous

0:35:520:35:55

glucose, because that blood sugar didn't come up,

0:35:550:35:58

but then she just suddenly spiked, and perfectly back to normal.

0:35:580:36:01

She admitted she hasn't been eating very well

0:36:010:36:03

and taking her meds as she should, so she's going to speak to the GP,

0:36:030:36:06

and get the district nurse to sort her out.

0:36:060:36:09

The daughter's a nurse as well, so we'll leave her to sort her mum out

0:36:090:36:12

and give her a telling-off!

0:36:120:36:13

But, yep, ultimate result was ideal.

0:36:130:36:15

Four months later, Pat has recovered from her episode,

0:36:150:36:19

but it seems she still hasn't learned her lesson.

0:36:190:36:21

I mean, she's been diabetic for a long time,

0:36:210:36:24

and she's got very blase with things that she eats

0:36:240:36:27

and how often she does her blood sugars.

0:36:270:36:30

Very often, she'll have a piece of chocolate,

0:36:300:36:33

and instead of having one piece, she'll have three pieces,

0:36:330:36:36

and the same with biscuits,

0:36:360:36:37

and she's very partial to a piece of cake, now and again.

0:36:370:36:40

John, the paramedic, was fantastic.

0:36:400:36:42

He was very reassuring.

0:36:420:36:45

He spoke to Mum continuously.

0:36:450:36:47

Without John, definitely, Mum wouldn't be here.

0:36:470:36:51

It was touch-and-go at that point, because her blood sugar was so low.

0:36:510:36:55

So it was the quick response of them getting round here,

0:36:550:36:59

and being able to act on her blood sugar quickly,

0:36:590:37:02

saved her life.

0:37:020:37:04

The profession of a paramedic is all about helping people.

0:37:110:37:15

When the elderly call for us,

0:37:150:37:16

it appears that they're quite brave-faced sometimes.

0:37:160:37:19

They seem to shrug off the sort of problem that they have at that time,

0:37:190:37:22

their long-term condition.

0:37:220:37:24

They almost treat us as sort of,

0:37:240:37:27

or treat themselves as being a hindrance to us,

0:37:270:37:30

which certainly isn't the case.

0:37:300:37:32

In Stourbridge, paramedic Ste Hill is working the late shift.

0:37:340:37:38

We're on the way to a 999 call to a gentleman

0:37:380:37:42

who looks like he's fallen on the floor and he's got a back injury.

0:37:420:37:46

The chances are he's just tumbled at home,

0:37:460:37:48

but particularly in the elderly, there's a chance of fractures,

0:37:480:37:50

which is greater than it would be in a healthier, younger, fitter person.

0:37:500:37:55

Hello?

0:38:060:38:07

Ambulance.

0:38:080:38:09

Hello there, young man.

0:38:100:38:12

Right, what's your name, mate?

0:38:130:38:14

-What's your name?

-Leonard.

0:38:160:38:18

-Leonard, hello. Do you like to be called Len?

-Len.

-Len. Hello, Len.

0:38:180:38:22

-What happened to you?

-I've fallen down and I can't get up.

0:38:220:38:25

-I've got a dicky leg, won't support my weight.

-OK.

0:38:250:38:29

Where have you fallen from, Len?

0:38:290:38:31

-Just off the chair.

-Have you injured yourself at all?

0:38:310:38:34

-No.

-Have you got any pains anywhere?

0:38:340:38:36

-No.

-All right. What I'm going to do, if it's OK,

0:38:360:38:38

I'll check you over top to bottom,

0:38:380:38:40

-to make sure you haven't hurt yourself.

-Fair enough.

-OK, mate.

0:38:400:38:43

All right, anything on your head at all?

0:38:430:38:45

-No.

-Any pain down your neck or your back?

-No.

0:38:450:38:47

Can you pop your legs flat on the floor?

0:38:470:38:50

-Very awkward.

-Can you move your legs for me?

0:38:500:38:52

Can you bend them up? OK.

0:38:520:38:54

All right. Let's just have a feel of your wrist.

0:38:540:38:56

I've got COPD and a dicky heart.

0:38:560:38:59

All right.

0:38:590:39:00

Did you just slip? Is that the reason you ended up on the floor?

0:39:000:39:03

OK.

0:39:030:39:04

COPD stands for chronic obstructive pulmonary disease,

0:39:040:39:08

a lung condition which makes breathing difficult.

0:39:080:39:12

All right, then. Thank God for that.

0:39:120:39:14

No problem. Can we do a few observations?

0:39:140:39:17

Check your blood pressure and whatnot?

0:39:170:39:19

-No problem.

-OK, mate.

0:39:190:39:21

Following Len's fall, we've got to rule out with Len's age,

0:39:210:39:25

any further injuries or medical conditions

0:39:250:39:27

that maybe could have caused his fall.

0:39:270:39:30

We're just going to do a routine sequence of checks now,

0:39:300:39:32

and make sure that everything's as it should be.

0:39:320:39:35

All being well, he'll stay here, I don't think he'll go to hospital.

0:39:350:39:38

OK, mate, it's just going to tighten your arm, OK.

0:39:380:39:41

Just pop these on your wrists and your ankles.

0:39:410:39:43

Right then, Len, this machine picks up any big movements,

0:39:430:39:45

so I just want you to relax for me, OK?

0:39:450:39:48

That's OK. Everything's OK.

0:39:560:39:58

We've done a full set of observations, everything is normal,

0:39:580:40:01

normal for him.

0:40:010:40:03

His ECG, his blood pressure, his oxygen levels, everything's good.

0:40:030:40:07

I think it's just a case now of making sure he's happy here at home.

0:40:070:40:10

-All right, Len?

-Can't grumble for 86.

0:40:100:40:13

It turns out that Len's fall was down to a war injury.

0:40:130:40:18

I got wounded in the Army in Korea

0:40:180:40:22

in that knee,

0:40:220:40:25

and it won't bear any weight.

0:40:250:40:27

Yeah. How did you get injured in Korea? What happened?

0:40:270:40:30

I was a clerk, believe it or not,

0:40:300:40:33

and the Brigade Major came to me and said,

0:40:330:40:37

"Corporal, can you read a map?"

0:40:370:40:39

And I said, "Yes, sir."

0:40:390:40:42

So he said, "Right, take these two trucks

0:40:420:40:45

"to 1st RAR and 2nd RAR."

0:40:450:40:48

-Yup.

-Which was up north,

0:40:480:40:50

where the Nationalists was,

0:40:500:40:53

and we was going across country to 2nd RAR

0:40:530:40:56

when the Chinese opened up with a heavy machinegun.

0:40:560:41:01

And they killed the driver.

0:41:010:41:04

-Yeah.

-And the round bounced off a rock,

0:41:040:41:07

and a piece of it hit me in the knee.

0:41:070:41:10

A piece of the rock, or a piece of the round?

0:41:100:41:12

-A piece of the round.

-Oh, right.

0:41:120:41:14

I drove the wagon myself up to 2nd RAR,

0:41:140:41:20

even with a bad leg.

0:41:200:41:22

-Were the Aussies grateful that you got the vehicle there?

-Oh, yeah.

0:41:220:41:26

Yeah? Did they know the trauma you'd gone through to get it there?

0:41:260:41:29

-I didn't tell them, did I?

-You kept that to yourself.

0:41:290:41:32

I told them about the poor driver being killed.

0:41:320:41:35

-Yeah.

-And falling out the wagon.

0:41:350:41:37

Yeah, of course.

0:41:370:41:39

I think you want a cup of tea, don't you?

0:41:390:41:41

-I'd love one.

-How do you take it?

-Three sugars, but not a full cup.

0:41:410:41:45

Three sugars, but not a full cup.

0:41:450:41:46

I dread to think how much sugar you'd have in a full cup, then!

0:41:460:41:49

Well, I've got a sweet tooth!

0:41:490:41:52

Let me get the kettle on.

0:41:520:41:54

Part of being a paramedic is how make a good cup of tea.

0:41:540:41:58

Our job's not always about sort of, like, patching up the injured

0:41:580:42:01

and really unwell people,

0:42:010:42:03

it's quite nice having a chat to the senior generation,

0:42:030:42:05

because they've got lots of life experiences.

0:42:050:42:08

I think he's enjoyed telling us the tale,

0:42:080:42:10

and we've enjoyed listening.

0:42:100:42:11

So it was nice to have a chat to somebody and you know they're OK.

0:42:110:42:15

Here you go, Len, tea's up.

0:42:150:42:16

Sweet, three sugars.

0:42:160:42:18

All right, Len. Lovely to meet you.

0:42:200:42:22

All right. I'm glad you're OK.

0:42:220:42:24

-OK.

-That's a fair old handshake.

0:42:240:42:26

You enjoy your cup of tea, all right?

0:42:260:42:29

-Yes.

-Goodnight to you.

0:42:290:42:30

-All right, we'll lock up as we leave. Bye-bye.

-Goodbye.

0:42:300:42:34

That was quite a nice story.

0:42:350:42:36

He's sustained an injury, and that's how we've come to meet him tonight.

0:42:360:42:40

So, obviously, he's survived the injury,

0:42:400:42:42

but that's how we've crossed paths tonight,

0:42:420:42:44

an injury sustained in the Korean War.

0:42:440:42:46

Sadly, seven weeks later, Len passed away, peacefully.

0:42:490:42:53

His family were happy for his story to be told.

0:42:550:42:58

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